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Prognostic implications of type 2 Diabetes Mellitus in heart failure with mildly reduced ejection fraction

Background: Data regarding the characterization and outcomes of diabetics with heart failure with a mildly reduced ejection fraction (HFmrEF) is scarce. This study investigates the prevalence and prognostic impact of type 2 diabetes in patients with HFmrEF. Methods: Consecutive patients with HFmrEF...

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Main Authors: Schupp, Tobias (Author) , Abumayyaleh, Mohammad S. A. (Author) , Weidner, Kathrin (Author) , Lau, Felix (Author) , Reinhardt, Marielen (Author) , Abel, Noah (Author) , Schmitt, Alexander (Author) , Forner, Jan (Author) , Ayasse, Niklas (Author) , Bertsch, Thomas (Author) , Akin, Muharrem (Author) , Akın, Ibrahim (Author) , Behnes, Michael (Author)
Format: Article (Journal)
Language:English
Published: 27 January 2024
In: Journal of Clinical Medicine
Year: 2024, Volume: 13, Issue: 3, Pages: 1-15
ISSN:2077-0383
DOI:10.3390/jcm13030742
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm13030742
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/13/3/742
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Author Notes:Tobias Schupp, Mohammad Abumayyaleh, Kathrin Weidner, Felix Lau, Marielen Reinhardt, Noah Abel, Alexander Schmitt, Jan Forner, Niklas Ayasse, Thomas Bertsch, Muharrem Akin, Ibrahim Akin and Michael Behnes
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Summary:Background: Data regarding the characterization and outcomes of diabetics with heart failure with a mildly reduced ejection fraction (HFmrEF) is scarce. This study investigates the prevalence and prognostic impact of type 2 diabetes in patients with HFmrEF. Methods: Consecutive patients with HFmrEF (i.e., left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Patients with type 2 diabetes (dia-betics) were compared to patients without (i.e., non-diabetics). The primary endpoint was all-cause mortality at 30 months. Statistical analyses included Kaplan-Meier, multivariable Cox regression analyses and propensity score matching. Results: A total of 2169 patients with HFmrEF were included. The overall prevalence of type 2 diabetes was 36%. Diabetics had an increased risk of 30-months all-cause mortality (35.8% vs. 28.6%; HR = 1.273; 95% CI 1.092-1.483; p = 0.002), which was confirmed after multivariable adjustment (HR = 1.234; 95% CI 1.030-1.479; p = 0.022) and propensity score matching (HR = 1.265; 95% CI 1.018-1.572; p = 0.034). Diabetics had a higher risk of HF-related rehospitalization (17.8% vs. 10.7%; HR = 1.714; 95% CI 1.355-2.169; p = 0.001). Finally, the risk of all-cause mortality was increased in diabetics treated with insulin (40.7% vs. 33.1%; log-rank p = 0.029), whereas other anti-diabetic pharmacotherapies had no prognostic impact in HFmrEF. Conclusions: Type 2 diabetes is common and independently associated with adverse long-term prognosis in patients with HFmrEF.
Item Description:Veröffentlicht: 27. Januar 2024
Gesehen am 05.06.2024
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm13030742

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